A nurse is reinforcing teaching to a client who is at 28 weeks of gestation and reports heroin use.
Which of the following statements should the nurse include in the teaching?
"The use of heroin can cause placenta previa.”.
"The use of heroin can cause preterm labor.”.
"The use of heroin can cause chromosomal abnormalities.”.
"The use of heroin can cause an increase in amniotic fluid.”
The Correct Answer is B
Choice A rationale
Placenta previa, a condition where the placenta partially or completely covers the cervix, is primarily associated with risk factors such as previous cesarean sections, multiparity, and advanced maternal age. Heroin use does not have a direct causal link to the development of placenta previa.
Choice B rationale
Heroin use during pregnancy is strongly associated with an increased risk of preterm labor. Opioids can cause uterine contractions and alter placental blood flow, leading to premature cervical changes and the onset of labor before 37 weeks of gestation, impacting fetal development.
Choice C rationale
Chromosomal abnormalities, such as Down syndrome or Turner syndrome, result from errors in chromosome number or structure during cell division. These genetic errors are not caused by maternal heroin use, although substance abuse can affect fetal development in other ways.
Choice D rationale
An increase in amniotic fluid, known as polyhydramnios, is often associated with conditions such as maternal diabetes, fetal gastrointestinal anomalies, or multiple gestations. Heroin use does not typically lead to polyhydramnios; rather, it is more commonly associated with oligohydramnios due to fetal growth restriction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Auscultating bowel sounds is an important assessment, but it is not the first action for a newborn with neonatal abstinence syndrome. Respiratory compromise is a life-threatening complication that requires immediate assessment to ensure adequate oxygenation and ventilation, as respiratory depression can occur due to central nervous system effects of withdrawal.
Choice B rationale
Swaddling can provide comfort and reduce hyperirritability in a newborn with neonatal abstinence syndrome. While beneficial, it is a supportive intervention. Prioritizing physiological stability, specifically respiratory status, is essential before implementing comfort measures to address potentially life-threatening complications.
Choice C rationale
Determining the newborn's respiratory rate is the first action because respiratory depression or distress is a critical and potentially life-threatening symptom of neonatal abstinence syndrome. Accurate assessment of respiratory effort, rate (normal range is 30-60 breaths/minute), and presence of retractions or nasal flaring is paramount to ensure adequate oxygenation and guide immediate interventions.
Choice D rationale
Weighing a wet diaper assesses hydration and urinary output. While important for overall assessment, it is not the immediate priority for a newborn experiencing neonatal abstinence syndrome, as respiratory stability takes precedence due to the direct threat to life that respiratory compromise can pose in these vulnerable infants.
Correct Answer is D
Explanation
Choice A rationale
Discussing a desire for more children is a normal manifestation of a positive postpartum adjustment. This indicates a healthy attachment to the current child and an optimistic outlook on future family expansion, reflecting psychological well-being and a positive coping mechanism in the postpartum period, not a concern.
Choice B rationale
Fatigue and a desire to sleep are common physiological and psychological responses to the physical demands of labor, delivery, and the initial postpartum period, as well as the demands of newborn care. This is a normal physiological recovery process and not indicative of a psychosocial concern.
Choice C rationale
Acknowledging similarities between the newborn and oneself as an infant indicates a healthy process of identification and bonding. This self-referential observation fosters a sense of connection and continuity within the family unit, signifying normal maternal-infant attachment and psychological integration, not a concern.
Choice D rationale
A client's reluctance to feed the newborn can be a significant indicator of potential psychosocial concerns such as postpartum depression, anxiety, or difficulties with maternal-infant bonding. This behavior may suggest a diminished capacity for engaging in essential caregiving activities, warranting further assessment and intervention.
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